Cole is right. Fallows is killing the ‘tubes these days. Case in point: this piece, in which Fallows in part channels another excellent post by Merrill Goozner, carries this title: Undoing Medicare: The Real ‘Death Tax.’
Here’s what Goozner said:
Seniors and the poor account for over half of health care spending. Within those groups, 5 percent of the population accounts for 50 percent of health care costs; and 20 percent of the population accounts for about 80 percent. These costs come for the most part at times when economic incentives have no influence at all on medical decision-making: in medical crises; in treating chronic conditions; and, for most Medicare patients, in the last six months of life.
__
That’s why a voucher program for Medicare, which will shift an increasing share of those inevitable costs onto the elderly themselves, can fairly be categorized as a 100 percent estate tax or death tax. People under 55 need to know that if the plan crafted by Rep. Paul Ryan were passed, most of them will never have a cent to leave to their children. It will all go to the health care industry to support the American way of dying.
And here’s Fallows’ conclusion:
If one major goal is containing overall health spending, it is flat-out delusional to think that older people, in their role as patients or individual purchasers of insurance policies, can be more effective negotiators than Medicare in its entirety dealing with the health system as a whole.
…
In short: the overall economic price tag for medical care is likely to go up under this plan; and the number of people who will have to live with worry about ruinous medical bills will be much greater. This is part of the reason why, until very recently, no “serious” person proposed getting rid of Medicare.
Exactly so. Fallows has nailed it — and you should head over there to read the whole thing, if only for the update containing the analysis by one of Fallows’ readers who correctly nails an error in Fallows’ reasoning about the death tax the Republicans seek to impose on Americans. It’s not as bad as argued above. It’s worse.
__
Image: Francisco de Goya, In the Plague Hospital, 1808-1810.
Villago Delenda Est
The vermin of the Village do not listen to adults, like Fallows. They listen to the Randroid three year olds like Paul Ryan and Rand Paul wailing “mine, mine, MINE!”
Bob Loblaw
I think the more important issue is who names their kid Merrill Goozner?
Redshift
It’s all part of the conservative plan to give everyone more “freedom,” except for the freedom to band together to have a chance against corporate power. It’s the pretense that because a few people may be able to learn how to work the system well and do better than professional managers with the clout of large groups behind them, everyone should be required to try.
It’s just like killing pensions and replacing them with IRAs and such. “You can get better returns investing your own money! (And by ‘you’, we mean ‘people with the right background and enough leisure time to devote to investing, as well as enough spare money they can afford to risk.)” Except that pretty much no one can do better without Medicare, except people with enough money that they don’t think they’ll ever need it.
handy
@Bob Loblaw:
Merrill’s not so bad. Did they really have a choice with Goozner?
El Cid
Look, if old people in the midst of catastrophic medical care need can’t be trusted to shop around and get the best bargains on their care, who can?
Omnes Omnibus
@El Cid: Many of them have children who I am sure would be able to take time away from work to solve these problems for their parents.
Catperson
@Redshift: We are all John Galt!
Until Enron fucks us over.
Catperson
@El Cid: I know my dad did his best negotiating from the ICU.
Delia
Hey, I’m waiting for the step that comes after they successfully shut down Medicare and require seniors to pay their last dime on medical bills. That’s when they go the full Chinese route and pass a bill authorizing insurance companies to go after the children’s and grandchldren’s property to settle up those unpaid bills. They’ll call it “family responsibility” or something.
Joseph Nobles
It occurs to me that Paul Ryan might have ownership of one or many of the reverse-mortgage firms out there, and shoving Grandma out onto the tender mercies of the insurance industry after hanging a nice little check around her neck is just his way of encouraging her to crack open her equity so everyone can have a slice. Is there any way to check that?
mvr
My only quibble is with the “until very recently” qualifier on the claim that no serious person has proposed getting rid of medicare. What recent serious person has? Of course some “serious persons” have.
mclaren
Everybody, Republicans and Democrats, avoids the basic issue with health care: you cannot get costs down in a for-profit fee-for-service fragmented system where every doctor and every medical devicemaker and every hospital and every imaging lab and every blood work lab tries to charge as much as the market will bear.
In order to force costs down, you must have one single payer who will say to the CAT scan labs, “No, we will not pay $1850 for a CT scan, we will pay only what the French government pays — $250.”
If you don’t have a single payer nationalized system, the individual imaging lab shrugs and says, “No problem, someone else will pay” and charges $1850 for the CT scan to some other entity that will pay it. State, local, county, employer’s insurer, whatever. Someone pays it in a system like that. Because in a fragmented system with a zillion different payers and payees, all making up different frees and using different fee schedules, the costs get passed on to someone else…always, the costs get passed on to someone else. Only in a nationalized single-payer system is the cost no longer passed on to someone else and the single true cost is revealed and the single payer can say, “No, that’s too much, we will not pay $1850 for a CT scan.”
Doctors just flat out lie about this. They lie and lie and lie. They claim “That isn’t the true cost, in France it’s subsidized.” The cost isn’t subsidized to the tune of $1500 per CT scan, if it was, France would be spending 5 times its GDP on health care alone, and France spends per capita less than half what we spend in America.
So when you talk to medical people about this stuff, they just lie. It’s total denial. They’re living in an alternative reality where health care is great and the American medical system is wonderful and all we need to do is make a few tweaks around the edges and everything will perfect.
Wag
Agreed. The only logical conclusion is that Fallows is shining his CV in anticipation of looking for a new gig after the Atlantic goes full metal glibertatian
MikeJ
If the Ryan plan were to pass it would certainly help my business plan. I’m going to Alaska, rounding up icebergs, and towing them back down here to Seattle. We have to have *something* to float our old people out to sea on.
El Cid
@Catperson: It’s not my fault if those undergoing bypass surgery refuse to be active consumers.
General Stuck
the entire Ryan plan is delusional. Hitting the nail on about any part of it is akin to shooting the barn with a scattergun, near impossible to miss. It was not a policy document, it was a fatwa on liberal progressism. A trial balloon with an ultimatum. If not now, then later, of, we are seceding in spirit from any idea of cooperation for compromise with liberals going into the future. And nothing is off the table.
SFAW
Actually, it’s spelled “Goozner”, but pronounced “Throat Warbler Mangrove … of Ulm”
El Cid
I didn’t see a mention here of how completely fucking nutso weird Roger Ailes is. Here he takes on the dangerous unbelievers at the tiny newspaper he himself owns.
The defenders of our conservative way of life, our sacred vows, and our belief in freedom.
Catperson
@El Cid: I agree. If they’re too
sedated on the ventilatorlazy to participate in the market they get what they deserve.El Cid
Oh, and as I’ve said way too many times: that money that Ryan’s / the GOP’s plan is supposed to kick in to fund your private Medicare insurance replacement?
You know, the $X,000 per year above which it’s out of your worn old pockets?
You will not get that. None of us would ever get that. Any part of it. It would vanish with the next’ budget crisis’, which could include anything from actual deficits to billionaires not having had a tax cut in over 6 weeks.
They would soon decide that we would all be much better senior shoppers for our health care if we just didn’t get any soshullist big gubmit nanny state help at all.
El Cid
@Catperson: Is it now illegal to read Consumer Reports via endoscope? If not, they really have no excuse.
Plus, I’m sure there’s an iPod / whatever app for doing comparative medical care shopping intravenously.
Catperson
@El Cid: LOL. You win.
Tangentially, I feel bad that I’ve confused Naomi Klein with Naomi Wolf all these years. Everyone should read The Shock Doctrine. Deficit fear mongering, “financial martial law”, throwing old people under the bus; it’s hard not to be pessimistic about what’s coming.
cckids
@El Cid: ok, wow, that is intensely weird and creepy. Who acts like that?
Catperson
@cckids: People with a massive sense of entitlement?
Villago Delenda Est
@mclaren:
This, this, this.
It is by design that the for-profit health care system’s costs keep going up. That’s where the profit is! It’s a self fulfilling prophecy that costs will go up, because one of the “costs” is the built in massive ROI for whoever is invested in it…doctors, administrators, health “insurance” outfits.
It’s a scam. It needs to stop. The American health care system has a voracious, cancerous tumor growing on it that will kill the patient if we don’t take action to destroy it.
El Cid
@Catperson: The Beauty Shock? The Doctrine Myth?
El Cid
@cckids: Right wingers with power. Especially rich right wingers.
And apparently powerful media barons in general.
Apparently you don’t get to run giganto-media corporations without first scooping a whole lot of crazybugs into your head and shaking vigorously.
Linnaeus
Maybe we should call Ryan’s plan the “Logan’s Run” plan. ‘Cause you better not get too old.
KG
@mclaren: a for-profit model could work, in theory. But it is one that would require patients (and probably primary care doctors) to negotiate with specialists (your CT Scam example). But as everyone else points out in this thread, you don’t always have the luxury of negotiating price. I went through this a year or two ago, I developed inflammation in my shoulder from swimming/water polo, but it was so severe that I was concerned that I had torn something. Went to the doctor and he told me to get an MRI. Insurance picked up part of the tab, but then I still got a bill for $800. I had bare bones insurance at the time, but still figure I’d have been ahead without the insurance (assuming I didn’t blow the premiums in the meantime on women and booze).
I’m moving in the direction of single payer if only because I can’t see how a free market works in practice. I’d rather pay taxes for a system that will actually work rather than premiums and deductibles that are going to cost me more.
Chris
“It will all go to the health care industry to support the American way of dying.”
We’ve been shortsighted in assuming that the main extraction-based industries are those that exploit natural resources like oil and gas. Banking and health insurance are even better and more sophisticated at sucking out wealth; it’s just that they do it directly from people and their pocketbooks instead of from dirty holes in the ground.
And at some point, everyone else in the economy should wonder why health insurance gets to be the main leech on the public body.
KG
FYWP for not recognizing the difference between a blocked word and a not blocked word.
Martin
@cckids: Republicans. You’ve never met one before?
And I just got off the phone with the advice nurse. I’m off to the dr tomorrow for a tetanus booster and an inspection of my bit of surgery. Got a mean splinter jammed down into one of my finger joints and I couldn’t bring myself to go to urgent care for a goddamn splinter so I hacked it out. Wifey narced on me while I was working on it.
I hate shots. I’m such a fucking little girl about getting shots. I already feel weird and anxious about it.
Yutsano
@Martin:
I absolutely HAVE to watch the needle go in. Like it’s almost pathological. Otherwise I’ll jump like mad. I’ve ruined more than one hypodermic needle like that. But at least you get a lollipop afterwards.
Comrade Mary
@Yutsano: Weird. I HAVE to look away at the moment the needle goes in for a blood draw, but I watch the whole process with great delight and curiosity afterwards. And I almost always compliment the phlebotomist lavishly, usually slipping in the word “deft”, because this is one group of people who really, really need the positive feedback. If they were not deft, I still thank them politely at the end.
(The only time I have ever jumped was when my finger was pricked at a blood drive, the needle ripped across my fingertip, some of my blood got on the nurse, and we both got AIDS tests. Not fun.)
Parallel 5ths (Jewish Steel)
@martin: Tetanus shots still make your arm ache for a couple of days. I can’t believe (here in the US with the best healthcare tout le monde!) they still smart like that.
Yutsano
@Comrade Mary: I lurve it when they use the vacuum tubes to get the blood out. You can actually somewhat monitor your pulse when the precious bodily fluid pulses into the tube. My brother’s ex was a phlebotomist, it ain’t exactly simple stuff to do.
@Roger Moore: I get my blood drawn for medical reasons all the time. That’s not the same as getting a shot, but needles very rarely bother me. Unless I can’t see them.
Roger Moore
@Martin:
@Yutsano:
Let me suggest that you try to avoid anything that requires you to get a lot of shots. When I was getting ready to donate stem cells, I was given a conditioning regimen of one shot in each arm for five days straight. They used the tiny little needles that feel about like a mosquito bite, but I can imagine it would be really bad if you had a thing about getting shots.
Mnemosyne
@Martin:
Giving someone a shot really is an art. When I gashed my thumb open on St. Patrick’s Day and ended up in urgent care, the nurse who gave me my tetanus shot was really great — I barely even felt it go in.
Of course, I was all feverish the rest of the day (stupid immune system!), but at least the shot itself didn’t hurt.
Parallel 5ths (Jewish Steel)
@Mnemosyne: Boy, ain’t it the truth. When ever a nurse tells me I have “shy veins” it’s prelude to me getting stuck like a pin cushion.
Martin
@Yutsano: I don’t mind watching it go in when I’m getting my blood drawn. That doesn’t bother me. I think I’m okay with stuff coming out of me, but not going in.
Hmm. That works on many levels, now that I think about it.
@Parallel 5ths (Jewish Steel): I’m so goddamn sore already from all the work I’ve been doing that I’m really not looking forward adding that to already arching arms. But priorities being what they are, I just told my wife I was instead going to make the appt for wed so I can go karting tomorrow night.
Yutsano
@Parallel 5ths (Jewish Steel): I swear the phlebotomist girls go crazy over me when I come into the lab. My veins jump right out and say, “Ohh HAI!” and I get poked easily every time.
(waits to see who grabs the low-hanging fruit.)
piratedan
@Yutsano: after being a platelet donor for about 20 years you do appreciate those folks that have the gift of finding you on the first shot. Pet peeve of mine is those folks that lie to kids about getting their shots, a little honesty goes a long way, tell ’em it will probably sting a bit but it won’t last long. Most kids hate being lied to, they’re eerily similar to voters in that regard, just tell what to expect and they’re fine.
Parallel 5ths (Jewish Steel)
@Yutsano: my mental pic of you just a little more Iggy Popesque
Mnemosyne
@Yutsano:
So since you’re here, Mr. IRS man — what happens if I sent in my return without the W-2s attached? Do I get a nasty letter telling me to send them ASAP, or does my return get rejected, or what?
Yutsano
@Parallel 5ths (Jewish Steel): I do sort of have the hair for it, especially now since I’m getting the Jew fro growing nicely. It’ll get beaten back into submission this weekend I’m hoping.
@Mnemosyne: It’ll most likely get processed just fine without a hiccup. You’re not required to submit them when you file electronically, so as long as the information can be verified internally (vee hav our vays!) you should be just fine.
Martin
@Roger Moore: A close friend of mine passes out every time he gets a sharp poke. A couple of years ago he needed to have a little outpatient procedure done and the doctor being extra cautious booked him into a proper facility and put him on all the equipment and discovered that when he passes out, his heart stops for about 30 seconds and then starts up again.
I try to think of him when I’m getting shots. I may be a little girl about it, but at least my fucking heart doesn’t stop when it happens. I don’t know why I can’t get past this. I hacked my finger up like I was dissecting a frog without a problem and I know that hurt a fuckton more than the shot will, but for some reason the shots just freak me the fuck out.
Parallel 5ths (Jewish Steel)
@martin: Look at it this way, if you get lockjaw you’ll start talking like Thurston Howell III. And then you’ll have no revolutionary man-of-the-people cred. Small price to pay , I’d say.
Oh, and the agonizing death. That too.
Yutsano
@Martin: Ahem:
https://balloon-juice.com/2011/04/18/but-i-prefer-alcohol-2/#comment-2540082
I still think yer funny tho.
Mnemosyne
@Yutsano:
Sadly, I filed on paper, which is one of the stupider requirements when you’re married filing separately. So they have my whole printed return, but no W-2s.
Roger Moore
@Yutsano:
My veins don’t pop out, but I’ve given enough times to have a nice blood draw scar on the inside of my left elbow. The nurse just has to hit the scar and everything works fine.
When I was younger and ethics rules about hitting up coworkers for research samples weren’t so tight, I worked with some immunologists studying neutrophils. This was bad news, because neutrophils have a life span of only about 24 hours. I was unlucky enough to be the donor the first time their experiments worked. After that, they hit me up for donations two or three times a week until my veins couldn’t take it and I had serious needle tracks. When nobody else could get blood out of me anymore, they stopped taking me to the regular phlebotomist and had the blood gas specialists do it. Those blood gas nurses were the best; they specialize in getting needles into people whose veins have been trashed.
Yutsano
@Mnemosyne: I bet Fresno processes the thing without a hitch. But just in case watch your mail: if they have any questions, they’ll contact you.
Roger Moore
@Martin:
Ouch. My blood donating buddy- it’s easier to come in when there’s peer pressure- got started partly to get over a fear of needles. She still needs to have the nurse hide the needle and has a tendency to get light headed after donating, but maybe hearing that will make her feel a bit better about it.
Sarah, Proud and Tall
Those few of you who have been reading my little stories from the beginning would recall the time I spoke about a young Sarah Palin and her generosity with the chamomile tea at the Miss Alaska beauty pageant back in 1984.
I didn’t see her for a long time after that, which was fine by me. I keep track of her though. I do like to maintain a close eye on the high functioning psychopaths who cross my path. I didn’t make it to the age of 92 by being stupid. I have a friend at the CIA office in Anchorage who owes me a good number of favors, and he sends me an email with updates on young Ms Palin every few months.
(Personal to Sexypants in Anchorage – Keep being a good boy or Mr Spanky will come out, and you know you don’t like that.)
Anyhow, in April 2008 I went on a trip to Grapevine in Texas. That’s where my son Jeremy lives with his wife Dogface and their loutish and ever expanding brood, whose names are Trail, Mammary, Tree, Bagpiper and Math (or something unfortunate like that).
I had a lovely time. I handed out presents and sweets and kisses. I gave the little ones too much red jello and then watched them vibrate around the house until their mother screamed at them. I snuck into Trail’s bedroom and cut off the horrible little rat tail he’d been growing and then planted the scissors on one of his sisters. There were indeed shenanigans.
When it came time for me to go home, Jeremy drove me to Dallas/Fort Worth to catch my plane. I let Tree and Bagpiper come to the airport because they’re the only ones I don’t actively dislike.
When we arrived I handed over some cash to the children, kissed them all goodbye and sent them on their way. I quite like airports – the sense of anticipation, the frenetic energy, the shops full of booze, the obligatory nuns, the hosties in their short skirts and tight pants. Being at an airport is an experience Grammy Sarah likes to experience on her own, thank you very much.
Eventually I went to the Delta desk where I was told that there was a problem with my plane, but they were going to fit me right in on an Alaska Airlines flight to Anchorage, which had a layover in Seattle, but which left half an hour before the flight I had booked. There are advantages to having been a frequent flyer since 1942. The nice young lady summoned up a nice young security guard called Trevor who shepherded me through to the front of the check-in queue and then very kindly walked me to my boarding gate. He was very pretty – blond, sweet and dumb – just like Grammy likes ‘em.
I knew from my briefing emails that Sarah was going to be in town for a Republican Governors Association meeting on energy policy, so I wasn’t surprised when I saw her waiting at the front of the line to board. What did surprise me was that she appeared to be fairly pregnant. My source hadn’t mentioned this to me at all.
I joined a group of old dears from the United Daughters of the Confederacy who were off on an excursion. I didn’t think Sarah would recognize me as I was wearing a pair of Jackie’s old sunglasses (which I snaffled one Christmas at the White House) and my new Candice Bergen wig, but it never hurts to be careful.
I peered out at her through the haze of White Diamonds, mothballs and urine smell that seemed to have enveloped me.
Sarah was wearing a cheap rip-off of a Dries Van Noten thigh-length coat – you could tell from the poor stitching on the collar and around the cuffs – and she was stuffed in to it fit to bursting, like Chris Christie in a thong. It looked for all the world like she’d swallowed a big square pillow. She was nattering away to a man with a face like a dyspeptic badger, who was wearing ski boots, a shell suit and a leather jacket with a Slayer logo on the back. I assumed this was Todd. He nodded agreement every now and then but didn’t appear to add much else to anything. While she spoke at him, she kept patting at her stomach like the baby was kicking.
I was a bit concerned about getting on to the plane without her seeing me, but fortunately a nice flight attendant spotted my Balenciaga jacket and my bespoke Dior shoes and took all us old biddies on to the plane first. Always wear your best to the airport. The gays like it and it can be worth an upgrade.
When Sarah saw that someone was getting on the plane before her, she made a face just like the one that Joan Rivers makes when you tell her there’s no more booze.
I hid in the middle of the group until we were on the plane, and then hunkered down in my seat right at the front with a strategically positioned newspaper.
When I woke up from my little nap, we were in the air and three-quarters of the way to Seattle. Most of the plane was dozing. I took a look around with my makeup mirror while I fixed my face. Sarah and the Todd were two seats behind me and across the aisle at the back of the first class section.
He was playing some kind of electronic game, and he sniggered occasionally like Muttley from Whacky Races.
She in the aisle seat reading Cosmo. Every now and then, at quite regular intervals of five minutes or so, she would let out a little noise and clutch at her stomach, then look around furtively, almost as if she was checking to see if anyone had noticed. This went on for the best part of half an hour.
Of course, all the hosties had on their best “not my problem” faces, so they barely noticed that she was there, let alone her rhythmic grunting.
Next, she jabbed Todd in the gut and made a gesture with her head. Todd reached into his bag and fished out a bottle of water. She had a drink and then, lowering the bottle down to seat level, she splashed water around her feet. A little bit went into the aisle and glistened there. She handed the bottle back to Todd, and then made a little “o” sound of surprise.
Whatever reaction she was expecting from the flight attendants, it did not eventuate.
She pouted for a while and then got up to go to the toilet up at the front of the plane. I pretended to be asleep, but I was wearing my sunglasses so my eyes were wide open. Just as she passed me, her entire baby-bulge moved directly downwards about eight inches and I saw the bottom of a bright green polyester cushion (with yellow flowers, no less) poke out from under the edge of her coat.
She grabbed at it and barely stopped it falling all the way out, then tried to shove it back in but only made it worse, looked around in panic and bolted for the toilet.
Todd didn’t notice and he only looked up from his game of Donkey Kong about twenty minutes later when she hadn’t come out and the steward had to knock on the door and make her come out because the plane was preparing to land.
I retreated behind my newspaper again, but I did see that when she sat down she called Todd a name that’s so nasty it isn’t even in my vocabulary.
When I woke up again, the plane was deserted and the nice gay flight attendant was shaking me by the shoulder. His name was José. He helped me off the plane and into a taxi and handed me his number as the car drove off. We write to each other every week, and he’s become firm friends with my nephew Charles and his flatmate Kevin, although I can’t imagine what the three of them have in common.
All in all, it was a very nice trip.
Martin
Shit, pie dough is fucking easy once you get the chemistry down. Start from Julia: 5oz AP flour, 2.5oz cake flour. 1/4 tsp salt, 2 Tbs sugar. 6oz unsalted butter cubed (1/4″), 2oz chilled shortening. 1/3C ice water. Mix everything but the last two together either in a food processor or stand mixer until the butter is busted up pretty good. Then dump in the shortening and add the water until the dough is the right consistency. Keep everything as cold (but not frozen) as possible because you don’t want the butter breaking down – you want it to stay solid. Once it’s mixed, turn it out on a floured surface and work any surviving butter into the dough with the heel of your hand. When it’s uniform consistency, split it into two equal balls, wrap in plastic wrap and stuff them in the refrigerator. Do. Not. Use. Until. The. Next. Day. Doughs like that need time to get all acquainted.
That’s her recipe. My only real modification is that I go with roughly 1/4C or a bit less of vodka or other suitably flavored alcohol straight from the freezer in place of the water at the end, and then just add in as much cold water as is needed to get the dough the right consistency – usually only about 2-3 Tbsp.
With Julias recipe, you want it as dry as possible to avoid gluten formation, but not so dry that it won’t hold together. That magic proportion was always tough for me to knock out consistency, but with the vodka approach, it’s a piece of cake. Just make it a bit too wet and you can always add flour as you’re rolling out if it’s too sticky. No matter what, you’ll wind up with less water than in the driest all-water recipe, and the result will be perfect.
The best approach to getting it dialed in is to make a batch, bake it the next day, see what you get, and make another batch and do this about 5 times in a row. That critique/fix cycle is pretty important in baking. If the dough is tough or chewy then it’s too much gluten, too much water. If it’s falling apart on you, then not enough.
I don’t sift or do any of that other than giving the dry ingredients a whirl before I dump the butter in. I keep the butter and shortening in the fridge so it’s always ready. On a busy night, I can knock out a batch of dough in about 5 minutes start to finish. There’s really no need to fuss over it.
Martin
Chris Christie in a thong? Not fucking helping my anxiety about needles, you know!
Yutsano
@Martin:
Ya already lost me. :) I keed I keed. Though you did remind me I need a kitchen scale.
@Sarah, Proud and Tall:
You owe me a metric tonne of brain bleach for this mental image, good madame. I shall drive over this weekend to collect.
joeyess
I have absolutely no confidence in the casual American political observer to be able to distinguish the nuance or right from wrong in this debate. It’s going to come down to who massages the message better.
And that doesn’t bode well for our side of the aisle.
Parallel 5ths (Jewish Steel)
@Sarah, Proud and Tall: Swounds! I knew it. Wait’ll Sully hears about this.
Parallel 5ths (Jewish Steel)
@Sarah, Proud and Tall:
This I like, too.
Sarah, Proud and Tall
@Yutsano:
No problem. Just ask for Marge Albrechtson when you get here. She’ll sort you out.
guachi
My mother had breast cancer about 10 years ago, when she was 53 and had health insurance.
For the past few years, she hasn’t had any insurance and is counting the days until she gets on Medicare. She’s told us that if she got cancer (or any serious illness) before then, she’d rather die than spend all her money and have nothing to pass to her kids.
In other words, Fallows is right.
burnspbesq
@Yutsano:
“vee hav our vays!”
It’s not like it’s some big mysterious thing. Form 941, the return your employer files every quarter for withheld income tax and FICA, has a schedule attached to it showing the wages paid to each employee.
The weird thing, which I found out when I was pulling the data together for my 2009 return, is that if your employer gives you an erroneous W-2 and you can’t get it corrected before you have to file your 1040, the Service expects you to file consistently with the erroneous W-2 and file an amended return once you get a corrected W-2.
burnspbesq
@Martin:
“Chris Christie in a thong?”
THAR SHE BLOWS! MAN THE HARPOONS!
R-Jud
@Sarah, Proud and Tall:
I never used to believe this until I tried it two weeks ago while traveling for business. LBD, nice shoes, Burberry trench coat: voila, first class upgrade.
Bruce S
Fallows is such a mild, reasonable sort that when he starts amping it up and running on all cylinders, A-you know he’s pissed and B-it’s potent stuff.
I was just about to post my favorite Fallows of the day, his put-down of the S&P brouhaha in a thimble, but checked back and found – of course – that it had already been given the spotlight treatment.
The Atlantic has some glaring examples of dead weight that are annoying and best ignored (no, actually NOT Clive Crook) but Fallows is a master journalist. His Blind into Baghdad was a landmark in early writing on the war.
Rich2506
Interesting anecdote, reminds me of the economic situation under slavery. Slaves would hoard cash, refusing to spend any of it until the day when they could negotiate their freedom with their masters. Then they’d transfer this really substantial lump sum to their master and only then could a black person think about spending for him/herself. Produced a very poor economic situation for everyone.
Alex S.
How often did Sully ever link to Fallows?
someofparts
The 50% saving rate in China jumped out at me. When there is no public health plan to cover final medical costs, the peasants save like mad.
I know that’s awful. You know that’s awful. Wall Street considers it the ultimate wet dream.
kay
It’s a wonderful piece. I wish liberals would promote that they’re good and serious on budgeting. Health care is a wonderful example because liberals have actual ideas (and Democrats have an actual law), where conservatives have really failed at cutting costs on health care.
I get the argument that talking about saving money somehow buys in to conservative “framing” or whatever, but I think that’s baloney.
No one in their right mind wants someone in charge who wastes their money.
Budgeting can be about good, responsible
stewardship of public funds, and liberals have the better argument on that, re: health care, mostly because conservatives have NO argument.
Ryan knows his plan won’t “save” money on health care, net. It’s yet another mechanism to shift costs. The costs don’t go away.
I think liberals should brag about being good with money as far as value and bang for buck, and seize that unearned “budget” mantle from conservatives.
I know it’s a harder sell, more nuanced, than bellowing about BIG GUBMINT but I think we can do it.
kay
Ryan’s plan to end Medicare is based on Mitch Daniels’ plan to end Medicaid. Healthy Indiana.
In some ways, Ryan’s plan is less realistic than Daniels’ plan, because Daniels’ did some serious cherry-picking of enrollees for Healthy Indiana, and Ryan won’t be able to do that, and, of course, Daniels’ relies on the fact that Medicare exists to promote Healthy Indiana. He was shifting costs from state provided uncompensated care to poor people, and he had all Indiana residents over the age of 65 IN MEDICARE, so they weren’t in play.
Healthy Indiana is a big flop, and there’s no earthly reason that Ryan’s national roll-out would be any different. There’s every reason to think it would much, much worse.
And Paul Ryan knows that. Mitch Daniels is their budegtary icon. They all follow him.
kd bart
“Fallows, Redux: The GOP Health Care Plan–Worse Than The Chicken At Tresky’s”
“Wheat. I’m dead and they’re talking about wheat.”
rikryah
I respect Fallows
Dennis SGMM
My dear mom’s brain cancer robbed her of her speech, her reason and her ability to control her bodily functions some months before it took her life. At the same time, my dad’s cancer had reduced him to a 98 pound collection of bones. They passed on within six months of each other. My wife and I divided our time between work (No Family Leave Act back then) and taking care of my parents. Not everyone gets hit that hard but I can assure you that I was in no shape to negotiate anything. Moreover, the notion that you can negotiate with an essentially monolithic health care industry (And one that is still AFAIK free from anti-trust regulation) is a cruel deception. They will charge you whatever they want to and if the price includes your home and your savings then so be it: they gotta’ take of their shareholders.
daveNYC
@Linnaeus: Don’t you mean Logan’s Hoveround?
Phoebe
@El Cid: One of the oft-repeated stories Obama told on the campaign trail was of his mother, on her cancer deathbed, having to be on the phone dealing with the insurance company who was trying to not pay her coverage. I was in the audience in Seattle when he told this story, and someone in the crowd yelled, “FUCKERS!” with real heat, and he, very calmly and quietly, said, “That’s what I thought.”
Boring note: I love it when I click on a link and a new window opens up. So I don’t have to hit the back button to go back to what linked it. More of this, please.
Phoebe
@Catperson: Holy mother of pearl, until your comment I also thought they were one
person. Thank you.
@Alex S.: Sully linked to Fallows all the time, approvingly. Also to TNC. Not just McMegan! I don’t know if he reads them as much as he used to now that he’s no longer at the Atlantic. I would hope so, of course.
Linnaeus
@daveNYC:
That’s probably a better term.
Martin
@Dennis SGMM: My mom volunteers at the hospital to negotiate with the insurance companies on behalf of patients. She’s very good at it, because she knows at least one C-level exec at nearly all of them, so she can name drop and bump way the fuck up the food chain in a hurry, but even with that in her pocket she says it’s just infuriating sometimes. Anthem California Blue Cross is the worst, by a country mile according to her – so much so that after weeks negotiating on behalf of one patient she called out the CEO at a public event and chastised him over it.
bjacques
@Sarah, Proud and Tall:
I love you.
@Delia:
They wouldn’t need to pass a law forcing children to shoulder their parents catastrophic medical bills. Instead, insurance companies could decide to issue policies to older people only if their children co-sign as financial guarantors. Don’t like it? In the Free Market, you can always shop around. Except all the other insurers would be doing the same thing.
Tom Levenson
@Dennis SGMM: I am so sorry to hear of this. Except for its vicious soon-ness, my mother’s death from lung cancer was perfectly handled by the medical system. She got great care; she was respectfully treated by the hospital staff at the end (and throughout her illness); and she died with complete control over the process — keeping her four children in line to the end.
Her doctors, nurses and the hospital that was her primary point of contact with the medical system had a lot to do with it. She was seen (and died) at Alta Bates Hospital in Berkeley, CA. I don’t think that the fact that the place was named after its founder, a nurse, is a coincidence. They are (or were then) caregivers there.
HyperIon
@mclaren ranted excellently….
i agree with everything you wrote.
THAT doesn’t happen very often.
HyperIon
@Parallel 5ths (Jewish Steel)wrote :
sorry to pick nits but….
this means “everybody” as in “all the world”
it does not mean “in the whole world” (dans le monde entier).
Wolfdaughter
@mclaren:
I agree with what you say about single payer being able to exert influence to cut costs of procedures down. But I have to utter mild disagreement with you about medical professionals.
First, they are also stuck in our extremely inefficient system. Most of them had nothing to do with all the rules currently in place about DRGs and so forth. I used to interview prospective medical students for the U of A Medical School, and almost all of them believed that single payer was a better way to go. I have health problems which land me in the hospital a couple of times a year, and the nurses, PCTs, and so forth, if the subject comes up, would also like to see single payer. There are still doctors, mostly getting on in years, and powerful members of the AMA, who still scream socialized medicine, oh noes! But to the best of my recollection, the AMA recently came out in favor of single payer.
I have LOTS of experience with health professionals at all levels. I am a retired medical librarian, and as I said above, my health isn’t the best, so I have to deal with a lot of healthcare professionals. Almost all of them are dedicated and conscienscious, and they don’t lie. I think you paint with way too broad a brush here.
The people holding us back from creating a much more efficient system are the insurance industry, almost all of the Republicans, and some Democrats, particularly those from Connecticut and other big insurance states.
Parallel 5ths (Jewish Steel)
@HyperIon: Really? Ha! Thanks. Pick my nits anytime, I’d prefer to be correct about stuff.
Wolfdaughter
@Martin:
Hi, Martin.
Dunno if this will help at all, but…
When is the last time you had a shot? They use much smaller gauge needles than in years of yore, so you may feel a tiny sting for a second, or sometimes nothing at all, depending on whether or not they hit a nerve. Shots really are much less traumatic than when I was a kid back in the 50s and 60s.